SILVER SOLUTIONS MEDSPA POLICIES & GENERAL CONSENT
Please sign below to indicate that you have read and agree to each policy.
I authorize the use and disclosure of my name, photo-graphic/video images, and/or testimonial for charting, educational and marketing purposes by Silver Solutions MedSpa. I understand that information disclosed pursuant to this authorization may be subject to redisclosure and may no longer be protected by HIPAA privacy regulations. The photographic/video images, and/or testimonial will be used for: charting, educational Purposes, social media and/or Advertising.
The above contains the entire Silver Solutions MedSpa policies and general consent. These policies supersede any prior policies, agreements, understandings, negotiations, whether written or oral. These policies can only be amended throughout a written document formally executed by all parties.
By Signing below, I acknowledge that I have read all the details in the above policy and consent form and will receive a copy of this form in email after it is signed.